脳出血を合併した抗リン脂質抗体症候群の1例

Cerebral Hemorrhage in a Case of Antiphospholipid Antibody Syndrome

　症例は36歳男性で，突然の右前頭頭頂部の脳出血による左半身麻痺と痙攣重積症にて発症したものである。基礎疾患と考えられるものはなく，CT，MRI，脳血管写や血腫壁・皮膚動脈バイオプシーにて異常を認めなかったが，血液検査でループス・アンチコアグラントや抗カルジオリピン抗体など抗リン脂質抗体を認め，抗リン脂質抗体症候群と考えた。抗リン脂質抗体は血管に閉塞的に働くことが多いが出血例の報告もあり，この症例も抗リン脂質抗体症候群に脳出血が合併したものと考えた。

We describe a 36-year-old man with antiphos-pholipid antibody syndrome complicated by cere-bral hemorrhage. In December 1991 he was brought to another hospital with sudden onset of left hemiparesis and status epilepticus. He had been well previously. A CT scan and MRI showed a cerebral hematoma located in the right frontopa-rietal region. Twelve days later he was transferred to our hospital. Although a CT scan, MRI, and cerebral angiography were repeated, they did not reveal any abnormality regarding an etiology. Only persistently abnormal finding in laboratory studies was positive for lupus anticoagulant and anticar-diolipin antibody, i. e. antiphospholipid antibodies. There was no serological evidence of SLE or other autoimmune diseases. Stereotactic biopsy of the hematoma wall and scalp artery showed no abnor-mality. Based on above findings we conclude that antiphospholipid antibodies have played an impora tant role for the hemorrhage. Antiphospholipid antibody syndrome should be considered in a case of an unexplained cerebral hemorrhage especially in a young and normotensive patient.